• Title/Summary/Keyword: complex fracture

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Sensory Impairment in Infraorbital Nerve Following Mid-Facial Fractures (중안면골절에 따른 안와하신경의 손상)

  • Lee, Hyun-Tae;Kim, Yong-Ha;Kim, Tae-Gon;Lee, Jun-Ho
    • Archives of Plastic Surgery
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    • v.38 no.1
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    • pp.43-47
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    • 2011
  • Purpose: Sensory impairment in infraorbital nerve is common symptom following mid-facial fractures. The purpose of this study is to document the incidence of sensory impairment in infraorbital nerve following midfacial fractures and its recovery. Methods: Three hundreds fourteen patients with midfacial fracture were included involving emergence areas of infraorbital nerve. Fractures were classified into zygoma fracture, maxilla fracture, complex comminuted fracture and pure blow out fracture. Neurosensory function was assessed with clinical symptoms and light touch test in infraorbital nerve regions. Patients were followed and sensory function was evaluated immediately, 1, 3 and 6 months after trauma. Results: The total series consisted of 198 zygoma fractures, 19 maxilla fractures, 30 complex comminuted fractures and 67 pure blow out fractures. The incidence of sensory impairment was 60% (63% in zygoma fractures, 84% in maxilla fractures, 93% in complex comminuted fractures, 31% in pure blow out fractures). Persistent sensory impairments were remained in 32% (33% in zygoma fractures, 47% in maxilla fractures, 73% in complex comminuted fractures, 6% in pure blow out fractures) 6 months after trauma. Younger patients had better prognosis than older patients in recovery of infraorbital nerve function ($p$ <0.05, $x^2$-test). Mean recovery time was 11 weeks. Conclusion: The incidence of post-traumatic sensory impairment was different according to fracture types. Age of patients and fracture type were important factors that influence to recovery of sensory impairment. Complex comminuted fracture had poor prognosis, and pure blow out fractures had better prognosis than other fractures.

Simulation of Bone Fracture Healing by the Complex System Rule (복잡계를 응용한 인체 골절치료 모델링과 해석에 관한 연구)

  • 문병영;박정홍
    • Journal of the Korean Society for Precision Engineering
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    • v.20 no.12
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    • pp.198-204
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    • 2003
  • The bone fracture healing is simulated by using one of the complex system rules, named cellular automata method. It is assumed that each cell has property of Bone, Cartilage or Fibrous connective tissue. Nine local rules are adopted to change the property of each cell against the mechanical stimulus, which consists of the strain energy density, and the existence of bone in the surroundings. Two dimensional sheep metatarsal model is considered and the bone fracture healing is simulated. The simulation results agree well with those obtained by using fuzzy logic model and experimental data. The cellular automata method found to be one of the simulation methods to express the bone fracture healing. The cellular automata method is expected to be effective in representing biological phenomenon.

Geometric and Kinematic Characteristics of Fracture System in the Sancheong Anorthosite Complex, Korea (산청 회장암복합체 내 발달하는 단열계의 기하학적·운동학적 특성)

  • Lee, Deok-Seon;Kang, Ji-Hoon
    • The Journal of the Petrological Society of Korea
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    • v.25 no.4
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    • pp.389-400
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    • 2016
  • The study area, which is located in the southeastern part of the Jirisan province of the Yeongnam massif, Korea, consists mainly of the Precambrian Sancheong anorthosite complex and the Jirisan metamorphic rock complex, the Mesozoic granitoids which intruded them. Several fracture sets with various geometric indicators, which determine their relative timing and shear sense, are well observed in the Sancheong anorthosite complex. The aim of this study is to determine the development sequence of extension fractures, the movement sense and development sequence of shear fractures in the Sancheong anorthosite complex on the basis of detailed analysis of their geometric indicators. This study suggests fracture system of the Sancheong anorthosite complex was formed at least through five different fracturing events, named as Dn to Post-Dn+3 phases. (1) Dn phase: extension fracturing event of NNW trend. The fracture set experienced the reactivations of dextral ${\rightarrow}$ sinistral shearing with the change of stress field afterward. (2) Dn+1 phase: extension fracturing event of (N)NE trend. The fracture set experienced the reactivations of sinistral ${\rightarrow}$ sinistral ${\rightarrow}$ dextral. (3) Dn+2 phase: extension fracturing event of NW trend. The fracture set experienced the activated of dextral shearing. (4) Dn+3 phase: extension fracturing event of N-S trend. (5) Post-Dn+3 phase: extension fracturing event of (E)NE trend. Dn deformation formed during the early Songnim orogeny. Dn+1 deformation formed during the late Songnim orogeny. Dn+2 deformation formed during the Daebo orogeny. Dn+3 deformation formed during the Bulguksa orogeny.

The Clinical Effects of Complex Korean Medicine Treatment in Patients with Cervical Spine Fracture Caused by Traffic Accident: A Report of 2 Cases (교통사고로 발생한 경추 골절 환자에 대한 한방복합치료 효과: 증례보고)

  • Han, Si-Hoon;Lee, Gi-Eon;Jo, Kyeong-Sang;Byun, Da-Young;Oh, Min-Seok
    • Journal of Korean Medicine Rehabilitation
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    • v.28 no.2
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    • pp.113-120
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    • 2018
  • The objective of this study is to report the effects of complex Korean Medicine treatment for 2 patients who had cervical spine fracture casued by traffic accident. We used acupuncture, pharmacopuncture, moxibustion and herbal medicine to treat patients with cervical spine fracture. We observed the changes of pain by Numeric Rating Scale(NRS), Neck Disability Index(NDI) and EuroQol-5 Dimension Index(EQ-5D Index). After complex Korean Medicine treatment, we found that neck pain was reduced and quality of life were improved by NRS, NDI and EQ-5D Index. Complex Korean Medicine could be effective for patients with cervical spine fracture caused by traffic accident.

Usefulness of the Blink Reflex Study as a Preoperative Evaluation in the Orbitozygomatic Complex Fracture (안와관골 복합체 골절에서 술전 평가로서 눈깜박반사 검사의 유용성)

  • Kang, Dae-Il;Park, Sang-Woo;Choi, Jae-Hoon
    • Archives of Plastic Surgery
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    • v.37 no.6
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    • pp.779-782
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    • 2010
  • Purpose: As the evaluation of the preoperative sensibility in the orbitozygomatic complex fracture, used by most surgeons, depends on the patient's subjective judgements, it is difficult to make generalization and to use it as an objective evaluation method. We used the blink reflex study to objectively evaluate injury to the infraorbital nerve. Methods: From December 2008 to November 2009, a total of 16 patients underwent the patient's subjective report on sensory symptoms and the blink reflex study preoperatively. Among patients having orbitozygomatic complex fracture of type III or more according to Henderson's classification and simultaneously suspected as being injured along the infraorbital nerve pathway, patients who had difficulty in checking preoperative sensibility and said 'normal sensibility' were selected as candidates. Results: Fifteen patients showed abnormal R1 on the fracture side. These results suggested that most of patients had injury to the infraorbital nerve. Conclusion: Contrary to the existing tests, the blink reflex study is a useful diagnostic tool in reflecting injury to the infraorbital nerve objectively.

A cohesive model for concrete mesostructure considering friction effect between cracks

  • Huang, Yi-qun;Hu, Shao-wei
    • Computers and Concrete
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    • v.24 no.1
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    • pp.51-61
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    • 2019
  • Compressive ability is one of the most important mechanical properties of concrete material. The compressive failure process of concrete is pretty complex with internal tension, shear damage and friction between cracks. To simulate the complex fracture process of concrete at meso level, methodology for meso-structural analysis of concrete specimens is developed; the zero thickness cohesive elements are pre-inserted to simulate the crack initiation and propagation; the constitutive applied in cohesive element is established to describe the mechanism of crack separation, closure and friction behavior between the fracture surfaces. A series of simulations were carried out based on the model proposed in this paper. The results reproduced the main fracture and mechanical feature of concrete under compression condition. The effect of key material parameters, structure size, and aggregate content on the concrete fracture pattern and loading carrying capacities was investigated. It is found that the inner friction coefficient has a significant influence on the compression character of concrete, the compression strength raises linearly with the increase of the inner friction coefficient, and the fracture pattern is sensitive to the mesostructure of concrete.

Surgical Methods of Zygomaticomaxillary Complex Fracture

  • Ji, So Young;Kim, Seung Soo;Kim, Moo Hyun;Yang, Wan Suk
    • Archives of Craniofacial Surgery
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    • v.17 no.4
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    • pp.206-210
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    • 2016
  • Background: Zygoma is a major buttress of the midfacial skeleton, which is frequently injured because of its prominent location. Zygoma fractures are classified according to Knight and North based on the direction of anatomic displacement and the pattern created by the fracture. In zygomaticomaxillary complex (ZMC) fracture many incisions (lateral eyebrow, lateral upper blepharoplasty, transconjunctival, subciliary, subtarsal, intraoral, direct percutaneous approach) are useful. We reviewed various approaches for the treatment of ZMC fractures and discussed about incisions and fixation methods. Methods: A retrospective review was conducted of patients with ZMC fracture at a single institution from January 2005 to December 2014. Patients with single zygomatic arch fracture were excluded. Results: The identified 694 patients who were admitted for zygomatic fractures from which 192 patients with simple arch fractures were excluded. The remaining 502 patients consisted of 439 males and 63 females, and total 532 zygomatic bone was operated. Orbital fracture was the most common associated fracture. According to the Knight and North classification the most frequent fracture was Group IV. Most fractures were fixated at two points (73%). Conclusion: We reviewed our cases over 10 years according to fracture type and fixation methods. In conclusion, minimal incision, familiar approach and fixation methods of the surgeon are recommended.

Effect of Complex Traditional Korean Medicine Treatment and Rehabilitation on Acetabular Fracture: A Case Report

  • Young Han Nam;Choong Hyun Han;Young Kyung Kim;Youn Young Choi;Eun Sol Won;Hwa Yeon Ryu;Hyun Lee;Jae Hui Kang
    • Journal of Acupuncture Research
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    • v.40 no.3
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    • pp.272-280
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    • 2023
  • This report presents the clinical progress of a 50-year-old male diagnosed with a left acetabular fracture and left rib fracture after falling from a height of 3 m. The patient was treated nonsurgically and underwent complex traditional Korean medicine (TKM) treatment and rehabilitation, including acupuncture, electroacupuncture, pharmacopuncture, bee venom, herbal medicine, physiotherapy, and moxibustion. Patient progress was assessed using the numerical rating scale (NRS), manual muscle test (MMT), and modified Harris Hip Score (mHHS). During 113 days of hospitalization, the NRS score decreased from 7 to 3, and the MMT grade increased to normal in the hip, knee, and ankle joints. The mHHS score increased from 26 to 99 points. Radiographs and computed tomography scans of the left acetabulum were obtained periodically, and fracture union was successfully achieved. To our knowledge, this is the first case report of complex TKM treatment and rehabilitation of acetabular fractures.

Orbital wall restoration with primary bone fragments in complex orbital fractures: A preliminary study

  • Jung, Joo Sung;Kang, Dong Hee;Lim, Nam Kyu;Kim, Hyonsurk
    • Archives of Craniofacial Surgery
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    • v.21 no.3
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    • pp.156-160
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    • 2020
  • Background: We have reported orbital wall restoration surgery with primary orbital wall fragment in pure blowout fractures using a combination of transorbital and transnasal approach in pure blow out fractures. However, this method was thought to be difficult to use for complex orbital wall fractures, since the sharp screw tip that fixate the maxillary wall increases the risk of balloon ruptures. In this study, we reviewed 23 cases of complex orbital fractures that underwent orbital wall restoration surgery with primary orbital wall fragment and evaluated the result. Methods: A retrospective review was conducted of 23 patients with complex orbital fracture who underwent orbital restoration surgery with primary orbital wall fragments between 2012 and 2019. The patients underwent orbital wall restoration surgery with primary orbital wall fragment with temporary balloon support. The surgical results were evaluated by the Naugle scale and a comparison of preoperative and postoperative orbital volume ratio. Complex fracture type, type of screw used for fixation and complications such as balloon rupture were also investigated. Results: There were 23 patients with complex orbital fracture that used transnasal balloon technique for restoration. 17 cases had a successful outcome with no complications, three patients had postoperative balloon rupture, two patients had soft-tissue infection, and one patient had balloon malposition. Conclusion: The orbital wall restoration technique with temporary balloon support can produce favorable results when done correctly even in complex orbital wall fracture. Seventeen cases had favorable results, six cases had postoperative complications thus additional procedure seems necessary to complement this method.

Zygomaticomaxillary complex fracture after two-jaw surgery

  • Park, Joseph Kyu-hyung;Kim, Sang Wha
    • Archives of Craniofacial Surgery
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    • v.21 no.5
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    • pp.301-304
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    • 2020
  • Orthognathic surgeries often utilize rigid fixation for stabilization of the osteotomy site. The longterm fate of rigid fixations is still under investigation, and whether they should be routinely removed is under debate despite their low complication rates. Here, we report a case where a 26-year-old man suffered high-velocity trauma to his face 7 years after a two-jaw surgery. Computed tomography examination revealed a zygomaticomaxillary complex fracture, and open reduction and internal fixation was performed along with anterior maxillary wall reconstruction using absorbable mesh. Intraoperative examination revealed a broken L-shaped titanium plate near the fracture site with multiple bony fragments near each titanium screw. The rigid titanium system may have caused comminution of the fracture pattern, worsening the severity of the fracture.